You Have a New Dependent

This Life Events Guide page has two sections - active employees and retirees. Please refer to the appropriate page section for information based on your employment status. This life event does not apply to survivors.

In the table(s) below, supplemental benefits refer to supplemental dental insurance (Select, Select Plus, and Preventive), vision insurance, and Accident Plan. You may not be eligible for all supplemental benefits. Visit the Dental Insurance, Vision Insurance, and Accident Plan pages to learn about eligibility.

For Active Employees

You have a new dependent due to:

Birth, Adoption, or Placement for Adoption
National Medical Support Notice
Paternity
Legal Guardianship
Transfer of Custody

Birth, Adoption, or Placement for Adoption - Active Employees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	Yes, also includes birth of grandchild from your covered dependent under age 18 (Your grandchild becomes ineligible at the end of the month in which the parent, your dependent, turns age 18)	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	No	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	See the You Gain Eligibility for Other Group Medical Coverage page for more information	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To enroll or add dependent: File an application with your employer within 60 days of the event To change plans: File an application with your employer within 30 days of the event	To enroll: File an application with your employer within 60 days of the event To change or cancel: File an application with your employer within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after receipt of the application	New coverage: Effective on the date of the event You must provide proof you gained comparable coverage to the supplemental plan in which the employee is canceling If approved to cancel, coverage will end the last day of the month after your other coverage begins

National Medical Support Notice (NMSN) - Active Employees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	Yes	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	No	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	See the You Gain Eligibility for Other Group Medical Coverage page for more information	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To enroll or add dependent: File an application with your employer within 60 days of the event To change plans: File an application with your employer within 30 days of the event	To enroll: File an application with your employer within 60 days of the event To change or cancel: File an application with your employer within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Plan change: Effective the first of the month on or after the receipt of the application	New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified

Paternity - Active Employees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	Yes	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	No	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	See the You Gain Eligibility for Other Group Medical Coverage page for more information	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To enroll or add dependent: File an application with your employer within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name To change plans: File an application with your employer within 30 days of the event	To enroll: File an application with your employer within 60 days of the event To cancel or change: File an application with your employer within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application Plan change: Effective the first of the month on or after the receipt of the application	Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application

Legal Guardianship - Active Employees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	Yes	Yes
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	No	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	See the You Gain Eligibility for Other Group Medical Coverage page for more information	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To enroll or add dependent: File an application with your employer within 60 days of the event To change plans: File an application with your employer within 30 days of the event	To enroll: File an application with your employer within 60 days of the event To change or cancel: File an application with your employer within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application	New coverage: Effective on the date of the event

Custody Transfer - Active Employees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	Yes	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	No	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	See the You Gain Eligibility for Other Group Medical Coverage page for more information	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To enroll or change plans: File an application with your employer within 30 days of the event	File an application with your employer within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	New coverage: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application	New coverage: Effective on the date of the event

For Retirees

You have a new dependent due to:

Birth, Adoption, or Placement for Adoption
National Medical Support Notice
Paternity
Legal Guardianship
Transfer of Custody

Birth, Adoption, or Placement for Adoption - Retirees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	No	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	Yes	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	Yes	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To change to family coverage or add a dependent: File an application with ETF (ET-2331) within 60 days of the event To change plans or cancel: File an application with ETF (ET-2331) within 30 days of the event	To enroll: File an application with the vendor within 60 days of the event To change or cancel: File an application with the vendor within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	Coverage change: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application	Coverage change: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application

National Medical Support Notice (NMSN) - Retirees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	No	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	Yes	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	Yes	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To change to family coverage or add a dependent: File an application with ETF (ET-2331) within 60 days of the event To change plans or cancel: File an application with ETF (ET-2331) within 30 days of the event	To enroll: File an application with the vendor within 60 days of the event To change or cancel: File an application with the vendor within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application	New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified Coverage change: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application

Paternity - Retirees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	No	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	Yes	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	Yes	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To change to family coverage or add a dependent: File an application with ETF (ET-2331) within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name To change plans or cancel: File an application with ETF (ET-2331) within 30 days of the event	To enroll: File an application with the vendor within 60 days of the event To cancel or change: File an application with the vendor within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	Birth certificate or statement of paternity is filed within 60 days of birth: Family coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: Family coverage is effective on the first of the month following the receipt of application Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application	Birth certificate or statement of paternity is filed within 60 days of birth: Coverage is effective on date of birth Application is filed more than 60 days after birth, without a birth certificate: Coverage is effective on the first of the month following the receipt of application Canceling coverage: Effective the last day of the month following receipt of the application

Legal Guardianship - Retirees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	No	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	Yes	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	Yes	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	To change to family coverage or add a dependent: File an application with ETF (ET-2331) within 60 days of the event To change plans or cancel: File an application with ETF (ET-2331) within 30 days of the event	To enroll: File an application with the vendor within 60 days of the event To change or cancel: File an application with the vendor within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	Change to family coverage or adding a dependent: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application	New coverage: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application

Custody Transfer - Retirees

	Health Insurance & Uniform Dental	Supplemental Benefits
Enrollment opportunity?	No	Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?	Yes	Yes
Change coverage from family to individual?	Yes	No
Change health plan?	Yes	n/a
Drop a dependent and keep family coverage?	No	No
Cancel coverage?	Yes	Yes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit application	File an application with ETF (ET-2331) within 30 days of the event	File an application with the vendor within 30 days of the event
Documentation required?	Yes	Upon request
Effective date	Change to family coverage or adding a dependent: Effective on the date of the event Plan change: Effective the first of the month on or after the receipt of the application Canceling coverage: Effective the last day of the month following receipt of the application	New coverage: Effective on the date of the event Canceling coverage: Effective the last day of the month following receipt of the application